SCOTT SIMON, Host:
AIDS experts from around the world met this week in Toronto for the 16th Annual International AIDS Conference. The World Health Organization reported there that just one in four people who needs AIDS drugs has access to them. But that number is increasing, especially in sub-Saharan Africa, where the number of HIV patients on drug therapy has passed one million. Kitty Felde of member station KPPC reports from Kenya, where church groups and faith-based organizations provide 40% of all health care in poor areas of the country, including for people with HIV/AIDS.
KITTY FELDE: It's the feast of Saint James, and at the Catholic parish of Holy Cross in the Nairobi suburb of Dandora, the pupils of the parish elementary school have prepared a special presentation.
W: (Unintelligible) you must listen to your leader. Whatever you do, be prepared. I repeat, be prepared. Remember, AIDS is running after you.
FELDE: AIDS is running after you, they chant, in a parish where an estimated one in five is HIV positive. AIDS education is the responsibility of everyone, including this group of khaki-uniformed eight-year-olds who chant explicit information about how to prevent the transmission of AIDS.
Unidentified Children: One, avoid sexual immorality. Two, avoid sexual relationships. Three, avoid sharing body piercing instruments. Thank you.
FELDE: Half a dozen years ago the parish started a tiny AIDS clinic on the parish grounds. This past year the clinic moved down the road to a larger building to meet the growing demand and because parishioners were embarrassed to be seen going into the building. This clinic is one of seven run by the local Catholic dioceses. Father Ed Phillips is head of the Eastern Deanery AIDS Relief Program. He spoke while driving through the poor suburbs of Nairobi.
ED PHILLIPS: We had a serious problem in the deanery in the early '90s, where people were dying of AIDS in all these parishes, and no one was talking about AIDS. And even more so, no one was talking about AIDS and poor people. And so the priests started to talk together and said, everybody's dying, what are we going to do?
FELDE: Funding was catch as catch can. Seed money came from Germany. And then in 2003 President Bush proposed spending 15 billion dollars on AIDS worldwide. Today 90% of the operating budget for these seven clinics, more than two million dollars, comes from PEPFAR, the President's Emergency Plan for AIDS Relief. The money pays for anti-retrovirals and other AIDS medications for more than 1,500 patients at the Dandora clinic alone. But one thing the clinics don't hand out are condoms.
ETTA BAGOUYA: We talk about, say, abstinence, as the number one. (Unintelligible) saying prevention from infection of sexually transmitted diseases, pregnancy.
FELDE: Etta Bagouya is clinical supervisor for the Eastern Deanery AIDS Relief Program.
BAGOUYA: And we also talk about being faithful to only one partner and it is important to know his or her HIV status as well.
FELDE: The Catholic Church doesn't sanction them for birth control or for preventing the spread of AIDS. Father Ed and his clinics are caught between the dictates of Rome and the needs of the Kenyans they serve. So their AIDS counseling often takes a brisk and clever walk along a theological tight rope.
BAGOUYA: We do not offer condoms. For those who really cannot abstain, we will talk about them, but we do not offer. So they'll go out and get the services elsewhere. We tell them where to get them.
FELDE: The Kenyan government pays for free condoms, which are widely available.
(SOUNDBITE OF CHILDREN SINGING)
FELDE: The Eastern Deanery Clinic in Dandora also relies on free labor, an army of health care volunteers. More than 100 parishioners like these women visit those who don't show up for appointments and distribute food supplements paid for by the parish.
JOSEPH: (Foreign language spoken)
FELDE: Clients like Joseph say the anti-retrovirals made available at this clinic have changed his life.
BAGOUYA: Okay, Joseph is saying at least life these days is not like long ago. You know, in African tradition, if you are so sick and you are beyond help, they take you home and wait for you to die there and they bury you. But there's a difference now. If you take your drugs, well, they no longer take you home. You take your drugs. You get well and you continue with your work.
The Eastern Deanery's Father Ed is a Vatican consultant on health. He's currently working on a study on prevention behavior that falls within the protocols of Catholic teachings.
For NPR News, I'm Kitty Felde.
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